Remission and Relapses in Children with Steroid Sensitive Nephrotic Syndrome in Umuahia, South East Nigeria

• Published in: West African journal of medicine Vol. 37; no. 5; p. 548
• Main Authors: Ibeneme, C A, Onuh, E F, Ezuruike, E O
• Format: Journal Article
• Language: English
• Published: Nigeria 01-10-2020
• Subjects: Child; Child, Preschool; Female; Humans; Hypertension; Male; Nephrotic Syndrome - drug therapy; Nigeria; Recurrence; Nigeria
• ISSN: 0189-160X

Steroid Sensitive Nephrotic Syndrome (SSNS) follows a relapsing and remitting course in many of the cases. Time for initial response to corticosteroids has been identified as a prognostic factor in idiopathic nephrotic syndrome.
To determine the time to initial remission as well as the pattern of relapses among children with SSNS in Umuahia South East Nigeria.
Records of children with SSNS from July 2013 to June 2018 were reviewed for responses to corticosteroid and relapses in their first year.
Twenty-four children with Idiopathic Nephrotic syndrome were followed up for one year. Male to female ratio was 3:1 of which fifteen (62.5%) responded to steroid and they were aged 2 to 9 years. Median time to remission was 14 days. Of the 15 steroid responsive patients, 11 (73.3%) were early responders while 4 (26.7%) were late responders. Six patients had at least one episode of relapse giving a relapse rate of 40.0%. Of these six, four (66.7%) were infrequent relapsers while 2 (33.3%) were frequent relapsers. Relapse rate was not significantly different across age groups (p = 0.622) and gender (p = 0.294). Presence of hypertension, haematuria and delayed time to remission did not significantly influence relapse. Acute respiratory infection was the most frequent trigger of relapse.
More than two-thirds of children with NS in our centre experience early steroid response while less than one-third respond after 4 weeks of therapy. Less than half of the children experience a relapse in the first year of follow up.